October is Eczema Awareness Month: Get the Facts From Leading Experts

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By : Suvarna Sheth

This month is Eczema Awareness Month, a campaign established by the National Ezcema Association (NEA) to help the general public know and better understand what it’s really like living with eczema.

The NEA estimates that 31.6 million Americans have some form of eczema.

“Through this awareness-raising month, we aim to reduce stigma and shed light on the true impacts of eczema by presenting a variety of opportunities for our ‘ecz-perts’ and our eczema warriors to share the facts and insights to educate others and ultimately help support the eczema community,” Julie Block, president and CEO of the NEA, told dLife by e-mail.

Eczema is a common, non-contagious group of dermatologic conditions that cause the skin to become red, irritated, itchy and/or inflamed.

The condition has several types, including atopic dermatitis (the most common form), contact dermatitis, dyshidrotic eczema, neurodermatitis, nummular eczema, seborrheic dermatitis, and stasis dermatitis.

Eczema symptoms can vary from person to person, but some common symptoms include dry, red, and inflamed skin, an uncontrollable urge to itch the affected area, and rough, leathery, or scaly patches on the affected area.

There is no cure for eczema, but there are many different types of treatments that your dermatologist can recommend.

One of NEA’s “ecz-perts,” Dr. Peter Lio, (left) clinical assistant professor of dermatology & pediatrics, Northwestern University Feinberg School of Medicine and board of directors and scientific advisory committee member, NEA shares some basic tips for someone struggling with eczema.

“Eczema can have a huge impact on the quality of life for those suffering from it and on the family and friends who support them,” says Lio, “Some basic tips include babying your skin because eczema skin tends to be very sensitive to harsh chemicals, strong fragrances, and abrasive materials.”

Lio says to use the gentlest cleansers, moisturizers, and aim for 100% cotton clothing. He says even silk clothing which has been shown to have a soothing effect on the skin. And in general, products labeled as “for eczema” or “for sensitive skin” are suitable.

The NEA has a comprehensive database of products that are generally acceptable for most patients with eczema. Lio also says it’s important to moisturize early and often.

“A big part of eczema for most people is a damaged skin barrier,” says Lio, “I like to call this ‘leaky skin’ because it can’t keep water in, and it lets allergens, irritants, and even pathogens in from the outside.”

The professor states that moisturizers–good ones at least–serve several purposes:

“They seal water into the skin, they keep out those allergens and irritants, and some even help nourish the skin with lipids and other components to help make it stronger over time, at least in theory,” he says.

Lio suggests if these tips are not enough, to seek the help of an experienced allergist or dermatologist to help guide you.

“There are actually a number of causes of ‘eczema’ in the broadest sense, and sometimes allergies, foods, and infections are playing a role that can be tough to sort out without some guidance,” Lio indicates.

As far as causes for eczema or atopic dermatitis, Dr. JiaDe Yu, (left) director of occupational and contact dermatology, department of dermatology, Mass General Hospital/Harvard Medical School tells dLife it’s an inflammatory skin condition that is due to a combination of genetic and environmental factors.

Like Lio, Yu says basic tips for patients with atopic dermatitis include gentle skincare and routine moisturizing. His gentle skincare recommendations also include staying away from potentially irritating or allergenic materials and products.

“Fabrics such as wool can be very irritating on the skin,” says Yu. “Using bland soaps and products that do not have fragrance is another recommendation I give my patients.”

He says bar soaps are preferable to liquid soaps because bar soaps, on average, contain less preservatives than liquid soaps.

“Fragrances are often irritating and are frequently also allergenic,” says Yu, “Even ‘gentle,’ ‘natural,’ ‘organic’ products can potentially cause skin allergies through the use of fragrances and other botanical products.”

He says bland emollients that are fragrance-free are usually recommended by dermatologists.

“We would also recommend creams and ointments but no lotions because the latter contains a higher amount of alcohol that can burn especially if applied to irritated skin.

Yu says he recommends sticking with fragrance-free detergents and avoid dryer sheets and fabric softeners if possible. Perfumes and cosmetics are also best avoided if eczema is flaring.

A Link between Eczema and Diabetes?

To Lio’s knowledge, there is actually a bit of a protective effect when it comes to the connection between diabetes and eczema.

“Those who have Type 1 diabetes are slightly less likely to have allergic diseases such as asthma and eczema,” says Lio, “This is a bit complicated, however, and my sense is that there is still a great deal of overlap in the real world: many patients have both.”

Lio says the most common associations with eczema are asthma, food allergy, and hay fever.

He states that food allergy is actually more common with increasing the severity of eczema.

“In the past few years there has been an explosion of other connections, including anxiety, depression, ADHD, and others, so I think we’re at the tip of the iceberg with understanding the complex patterns here,” he adds.

Yu agrees with Lio in that the most well-established connection between atopic dermatitis and other diseases is with other allergic type-diseases including asthma, hay fever, and allergic contact dermatitis.

“These diseases are all related usually children with atopic dermatitis will have either a personal or family history of asthma or hay fever,” Yu says. “Some studies have shown that atopic dermatitis can be associated with various other health conditions including increased risk of heart disease, some autoimmune diseases, and increased risk of depression.”

However, he points out that more studies are necessary to prove that there is truly a correlation.

Also, Yu points out the link between atopic dermatitis and diabetes is not well established. “Some studies demonstrate there may be a relationship while others do not. The jury is still out,” he says.

Can Eczema Complicate Diabetes?

While there is no known connection between diabetes and eczema, Lio says eczema can “absolutely” complicate diabetes care.

“Eczema is itchy, inflamed, and frequently gets infected which can make it significantly more worrisome in a patient with established diabetes for whom infections can be more serious and more difficult to treat,” Lio says.

“Eczema also entails using topical corticosteroids frequently which–in some settings–could worsen and perhaps even increase the risk of new-onset diabetes,” he says. “For patients already dealing with one condition, the addition of another is especially unwelcome and makes us have to be very thoughtful about our treatment approaches.”

Yu agrees that atopic dermatitis can definitely complicate diabetes care.

“Some treatments used in atopic dermatitis routinely include topical or systemic steroids,” he says “These can lead to higher blood sugar in patients with diabetes.”

Furthermore, Yu explains patients with diabetes on average have dryer skin which may worsen atopic dermatitis as well.

“Skin damage in the setting of atopic dermatitis can lead to an increased risk of infections from bacteria and viruses that live in our surroundings including staph aureus, herpes virus, wart virus, fungal infections, etc,” says Yu.

He indicates patients with diabetes who may have compromised immune systems need to pay particular care to make sure their atopic dermatitis is well controlled and consider consulting a board-certified dermatologist to optimize care of their skin.

“Eczema is pretty crummy for everyone,” says Lio, “Our goal is to make sure we have the correct diagnosis, explore any underlying causes or triggers, and develop a treatment approach to keep things clear safely.”

He believes that with good care many patients can regain control over itchy, inflamed skin and get their life back.

Yu says there are great resources available for patients with atopic dermatitis.

He directs patients to look at official websites by leading societies such as those listed below.

“I would avoid private or personal blogs, social media, and advertisements for medical information as many can be misleading and are not evidence-based,” Yu also adds.

Additional Resources:

View and share the following video by NEA:

Sources:

1. Cardwell CR, Shields MD, Carson DJ, Patterson CC. A meta-analysis of the association between childhood type 1 diabetes and atopic disease. Diabetes Care. 2003 Sep 1;26(9):2568-74.

2. Ahn HJ, Shin MK, Seo JK, Jeong SJ, Cho AR, Choi SH, Lew BL. Cross-sectional study of psychiatric comorbidities in patients with atopic dermatitis and nonatopic eczema, urticaria, and psoriasis. Neuropsychiatric Disease and Treatment. 2019;15:1469.)

3. Van der Linden MW, Penning-van Beest FJ, Nijsten T, Herings RM. Topical Corticosteroids and the Risk of Diabetes Mellitus. Drug safety. 2009 Jun 1;32(6):527-37.

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